He said the presence of blood in the respiratory system indicated that she was still breathing when she was pinned down.

He said the child could have either been pressed down to the floor or pinned down by an adult, as there were injuries to the right side of her face.

Dr Zahari said there were also injuries on Wan Xuen's hands, legs, body, neck and lips.

He was testifying in the case of a family charged with negligently causing the death of Chua Wan Xuen, aged two years and nine months, during an exorcism ritual.

In the dock were parents Chua Seng Ban and his wife Lim She Lee, both 35, who had pleaded not guilty - along with five other relatives - to causing the death of their daughter Wan Xuen, through a rash or negligent act.

They are charged with committing the offence at a house in Bukit Tengah near Bukit Mertajam, between 7.50pm and 10.52pm on Aug 5, last year.

The eighth person involved was their Indonesian maid who was made a prosecution witness and testified against the family last year. Dr Zahari said he carried out the post-mortem at the Seberang Jaya Hospital the next day, on Aug 6.

He said he also went back to the crime scene later, after the case's investigating officer provided him with more details, which further assisted him in his forensic analysis of the case.

Apart from the forensic report, Dr Zahari also furnished the court with photographs of the toddler's body, which showed the physical injuries that she had sustained.